Sunday, August 19, 2012

I’ve already written about the overuse of antibiotics in this country. This overutilization costs money and causes medical complications. It also is believed to be the cause of a new generation of superbugs, that can attack us with impunity as we may have no effective antibiotic to defend ourselves with.

As an aside, I remember when I first learned the meaning of the word impunity. Here’s the opening paragraph from the short story written by a nineteenth century master.

THE thousand injuries of Fortunato I had borne as I best could, but when he ventured upon insult, I vowed revenge. You, who so well know the nature of my soul, will not suppose, however, that I gave utterance to a threat. AT LENGTH I would be avenged; this was a point definitively settled -- but the very definitiveness with which it was resolved precluded the idea of risk. I must not only punish, but punish with impunity.

Without resorting to Google, can any readers name the work and the author?

Digression over. Antibiotic (ATB) overutilization is not just an issue that affects man; it affects beasts also. Farmers have been prescribing antibiotics to fowl and cattle for years to make their animals heartier. This issue falls under the jurisdiction of the Food and Drug Administration (FDA), who have imposed restrictions on ATB use in livestock over the years. There is tension between those who feel that ATB should be banned and those who favor a more permissive policy.

Surprisingly, more antibiotics are prescribed to animals than to humans in this country.

Farmers and veterinarians feel they should be free to prescribe ATBs to keep their animals in good health. Antagonists claim that ATBs should not be allowed simply to prevent infections that result from unsanitary conditions. Moreover, there is a widespread view that overutilization of ATBs in cattle creates superbugs that can threaten humans. Farmers counter that these fears are hyped.

These are real issues that need real science to separate facts from politically correct arguments.

(1) It’s true that ATB use in cattle and livestock have increased.

(2) It’s true that superbugs are on the rise.

(3) This does not mean that (1) has caused (2).

The FDA has tightened the rule requiring now that farmers will need veterinarians' prescriptions for antibiotics, a requirement that is expected to substantially decrease their use.

I’m inclined to agree that both animals and humans receive more ATBs than they need. But, I wouldn’t want to create new mandates based on a hunch or even a logical belief. Before we adopt policies that affect industries, livelihoods and jobs, let’s ask ‘where’s the beef?’

Lisa, bullseye! Whistleblower readers are so erudite. Suji, if humans are consuming meat that was treated with antibiotics, then we may also be ingesting germs that are resistant to antibiotics. When one branch of the food chain is disrupted, the whole tree is affected.

I keep a small flock of sheep; mostly for wool, but I do eat the extra boys and retired ewes. I have a great relationship with my vet and I'm very judicious in my use of veterinary drugs.

There are definitely times when an animal is too sick to wait for lab results and we just have to make our best guess in administering an ATB in hopes that we're dealing with a bacterial infection. if it looks like I'm going to lose an animal to pneumonia, might as well treat for pneumonia instead of doing nothing and finally getting a diagnosis while digging a grave!

I'm grateful that there's still a pretty good range of vet drugs available OTC, but this is changing b/c so many farmers administer drugs indiscriminately. Good barn hygiene is practically free and a much more effective method than constantly wrestling animals in order to pump them full of drugs! A big worry for farmers right now is drug resistant parasites from overuse of wormers. It's worth the effort to run fecal testing in a symptomatic animal and treat specifically for a confirmed infestation, rather than prophylactically treating the whole flock.

I've definitely seen 1st hand that drugs lose effectiveness with inappropriate use. When an animal isn't treated long enough and relapses, the same drug doesn't work nearly as well the 2nd time around.

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About Me

I am a full time practicing physician and writer. I write about the joys and challenges of medical practice including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When I'm not writing, I'm performing colonoscopies.